Three cases of histiocytic necrotizing lymphadenitis without granulocytic infiltration with some atypical features – an expanding spectrum

Since the first description by Kikuchi and Fujimoto et al of ‘lymphadenitis showing focal reticulum cell hyperplasia with nuclear debris’ and ‘cervical subacute necrotizing lymphadenitis’ respectively, the clinical, morphological and immunohistochemical findings of this distinct clinicopathological entity have been extensively reported and described. Detailed descriptions of the morphology and immunuophenotype of the cells involved in this disease and association with a range of aetiologies have been reported. However, the aetiopathogenesis is still unknown. We report three cases of Kikuchi–Fujimoto disease which posed diagnostic difficulties and highlight the use of clinicopathological correlation given the absence of any one diagnostic histological, laboratory or immunohistochemical feature.